Ask a psychologist | How can I enjoy family gatherings (without losing it)?

by Jonathan Danson, PhD, Clinical Psychologist
as told to Tania Haas

Family gatherings are often thought of as times to talk, laugh, reconnect and reminisce. For others, however, these dinners or parties are dreaded and, if possible, avoided. As a psychologist, this matter peaks around the holidays, when some clients feel it is a good time to break from therapy and others double up on their sessions. For those who cringe at the idea of spending time with your warring family, oversharing uncle, judgmental parents, bully of a sister-in-law, or whatever other version of dysfunction that makes gatherings a strain, here are some tips to help get you through them relatively unscathed.

Plan ahead.

Before the event, consider which topics you’re comfortable taking about and which are off limits. How might you respond to unwelcome or prying questions? I suggest you keep responses to these questions concise (“that’s not something I want to talk about”), and don’t feel obligated to provide an explanation. When we are caught off guard, we are more likely to overshare, find ourselves talking about something we wish we weren’t, or being overly harsh in our rebukes. A little bit of planning can go a long way in preparing you to respond effectively.

Pick your battles.

When we have differences of opinions from family members, it can be difficult to hold ourselves back from getting into old debates. This is especially the case when those opinions are extreme or relate to sensitive topics like politics. Before engaging in a verbal sparring match, consider what your goal is and whether you’re likely to be heard. When you don’t think arguing will help you meet your goals (e.g., if you know someone is not going to change their opinion, or you want to prioritize keeping the peace), it is likely better to back off. Think of it as doing what is effective over what might be justified.

Practise mindfulness.

Mindfulness is all the rage today, and for good reason. Among other benefits, building skill in mindfulness has been shown to help with stress reduction. If you already cultivate a mindfulness practice, try to apply those skills during the event. If you’re not too familiar with mindfulness, consider trying some guided meditations in the days leading up to the event (e.g. using the Headspace app). This won’t necessarily make the event more pleasant, but it may help you stay rooted in the present rather than getting lost in past frustrations, conflicts or old wounds.

Limit alcohol.

Faced with yet another stressful family event, you might be tempted to drink to take the edge off. While this might feel like it provides some relief, it also puts you at higher risk for crossing boundaries, saying things you don’t mean, and having trouble managing your emotions. If you feel that drinking might be the only way to get through the event, it might be time to leave.

It’s okay to leave.

If you’ve decided to go to a family event despite your expectations that it will be unpleasant, you likely feel that there are benefits to attending. You might feel obligated to be there or know that not going will cause you even more headaches later. That being said, there does come a point where leaving is the best choice. If you feel that things are about to turn sour, that you’re going to lose control, or that staying will cause you undue stress, there is no shame in walking out the door.

In the end, even with the best use of these and other strategies, family gatherings might remain unpleasant and intolerable. Just know that you are not alone, and make an effort before or after to spend time with people you truly do feel connected to.

Ask a psychologist | 4 back-to-school stress busters

Many people — some kids, most parents — are thrilled when school resumes. But along with the excitement of new beginnings comes back-to-school stress, which can affect both students and their parents.

“Stress is one of those things that doesn’t care if it is a positive or a negative,” says Dr. Mark Rothman, a psychologist at Medcan who works with children, youth, couples and families. “It is cumulative. So when your little stresses add up, they become big stresses. Then our body and our mind is fighting that stress; and that’s what depletes us.”

The best way to offset the negative stress at this time of the year, is to be proactive and prepared — with an emphasis on the ‘pre’. Anything you can do in advance, get done as fast as possible says Dr. Rothman.  Here are four back-to-school stress busters from Dr. Rothman.

Carve out regular time for ‘school-related material’

Ensure that the routine after school includes regular time for “school-related material time”.

“Calling it ‘school-related material time’ makes it a regular occurrence, even when kids say they have no homework,” says Dr. Rothman. “Even without homework, there’s a designated daily time when school-related material is reviewed, addressed or organized.”

This creates a regular schedule for at-home review and study sessions.

Parents must practice their routines, too

Just like students must return to a routine, parents should adopt their school routine: making lunches, managing clothes or uniforms, getting the car ready and ensuring the fridge is stocked with healthy back-to-school foods for lunches, snacks and dinners.

“Doing this type of preparation now minimizes the stress that we experience at the time that the transition takes place,” says Rothman.

At university: Make time management a priority

One of the biggest stresses that university-aged people have is time management. If possible, find a mentor or role model at school — maybe an older student or floor don — who can help suggest a reasonable schedule that includes both recreational and study time.

“It’s important to add routine where it doesn’t exist because in university you aren’t in school 8 a.m. to 4 p.m. Many schedules are very irregular,” says Dr. Rothman. “I recommend students approach school like a full-time job, and put 10 hours a day into school, every day.

“Maybe one day, a majority of that time is in class. Other days, that means you are doing self-directed or group study. Even if you don’t have class, dedicate a set amount of time to study every day. The other hours are designated for socializing, exercise, relaxation and rest.”

Dorm room check-in: Set weekly communication times

As for parents and university-aged kids: there’s a transition period when kids leave the nest for school.

“Some parents can feel very very taken for granted when their child doesn’t keep in touch, while university students could feel smothered if their parents are trying to get in touch regularly,” says Rothman, who recommends a dialogue to set up expectations of communication.  “This is really helpful to avoid parents waiting around and their kids not understanding why there’s anger or sadness when they do make contact.”

The solution? Create “contact times”, which are regularly established times for communication.

“Rather than waiting it out and seeing what it is like; create a plan, and then you can always change the plan. So if it is understood that we will talk on Thursdays or Sundays around 8 p.m. for 10-15 minutes and if those days/times don’t work — you just adjust. No problem! But at least it is a start.”

Finding hope and help after high-profile deaths

Are you or someone you love having thoughts of suicide?  If at immediate risk, please call 911 or go to your nearest emergency department.  Or you can get support from the Canada Suicide Prevention Service by phone, text or chat. Resources here. 

On the day the world learned of Anthony Bourdain’s suicide death, journalist Andrew Solomon’s essay “Bourdain, Kate Spade, and the Preventable Tragedies of Suicide” was published in The New Yorker. Solomon, a professor of clinical psychology at Columbia University and repeat TED talk speaker on mental health, wrote about the pattern of highly accomplished people dying by suicide, and how it can both transfix and harm us.

That same week, the CDC reported that since 1999 U.S. suicide rates are up 30% and are now a leading cause of death. In Canada, the statistics have a similar direction. There is a narrowing in the ratio of male-to-female suicide rates, which reflects the accelerated increase in female suicide rates. In our military community, former Canadian soldiers are killing themselves at a significantly higher rate than that of the general population. In the weeks that followed the suicide deaths of Spade and Bourdain, a flurry of reports and opinions were broadcast, many promoting misleading conclusions and assumptions.  I reached out to psychologists and psychiatrists at Medcan in search of clarity, hope and how to seek help.

“It assures the rest of us that a life of accolades is not all that it’s cracked up to be and that achieving more will not make us happier (…) Those of us who have clinical depression can feel the tug toward suicide amped up by this kind of news. The gap between public triumph and private despair is treacherous, with the outer shell obscuring the real person even to those with whom he or she had professed intimacy.”

— Andrew Solomon, The New Yorker, June 8, 2018

Suicide is preventable. Help is available.

Suicide is far more complex than headlines make it out to be. Clinical research, however, is certain that mental health issues are a key component of factors contributing to suicide. “More than 90% of people who take their lives by suicide have an underlying psychiatric illness that is potentially treatable,” says Jodi Lofchy, MD, FRCPC, a psychiatrist at Medcan, the University Health Network, and an associate professor at the University of Toronto. “There are treatments available and life will look very different and well again. If you are suffering, reach out and get help. Concerned friends and family should also be aware of resources – from family doctors to emergency services – to connect their loved ones to.” With proactive medical screening, asking and monitoring through social relationships, suicidal feelings can be recognized, and addressed through the right medical channels.

Suicidal thoughts are a sign to seek help. Recognizing them is a sign of strength.

“People who have struggled with suicidal thoughts or have attempted suicide can, and do have fulfilling and active lives,” says Gina Di Giulio, LLM, PhD, Clinical Psychologist and Director of Psychology at Medcan. “Admitting how you are feeling to yourself, and then to others, is a sign of strength. Having the conversation with someone is not a sign of weakness; it takes incredible courage to open and admit to difficult feelings. Openness leads to accessing help that is available and can prevent suicide.”

With the right support, life will look very different, and well, again.

Suicide is often referred to as a permanent solution to a temporary problem. It is often considered when someone faces challenges or obstacles that have no sense of resolution at the time. Depression, relationship problems, addiction, financial difficulties – these are usually time limited or can be solved, says Dr. Di Giulio who works with clients using a problem-solving, structured therapeutic approach aimed at solving or ameliorating problems that clients often believe to be insurmountable. Finding and holding to hope is key. The number one predictor of suicide is a sense that of hopelessness; that things won’t get better. “Social isolation or seeing yourself as a burden to others can be a risk factor,” says Ricardo Flamenbaum, Ph.D., C. Psych., also a psychologist at Medcan. “Conversely, research shows that a sense of connectedness and belonging is an important protective factor.” Dr. Flamenbaum’s dissertation focused on identifying psychological predictors of suicide, and he has published research in the areas of perfectionism and chronic pain as well.

High performance is not a protective factor to suicide. Reaching out for help is.

Even the highest performing people are at risk to suicide. Michael Phelps, the most decorated Olympian of all time, has shared his battle with depression and suicidal thoughts. He has said how grateful he was that he didn’t take his own life. “Having a perceived sense of purpose is very important. However, it is also possible to be depressed or suicidal even if one has a purpose, so it is not deterministic in that way,” says Dr. Flamenbaum. “One of the challenges with depression is that it involves a distorted view of oneself, the world, the future. So even if one has very meaningful activities and relationships in one’s life, depression may cause the individual to fail to appreciate or recognize them.” Having a purpose, determining your why, having strong social connections – these are all important for performance and for imbuing meaning into your life. But they aren’t always enough of a protective factor against suicidal tendencies. Opening up and seeking support are.

Depression and suicidal thoughts can affect anyone

There are populations that are more at risk than others: having a history of suicidal thoughts or attempts, or clinical anxiety or depression can place someone into a higher risk category. Among vulnerable individuals, even just reading about suicide deaths can further increase risk. There are other factors contributing to one’s susceptibility to suicide: sleep and technology are just two to consider. Sleep deprivation has a devastating effect on mental health; 40% of adult Canadians suffer from sleep disorders. While habitual technology habits can create incredibly alienating cultures; isolation being another significant suicide risk.

Suicide is a public health issue. Clinicians, employers must be proactive.

In 2014, I wrote about the need to break down barriers to teen mental healthcare for Canadian teenagers for a cover story in Hospital News. The lessons then shared by the pioneering psychiatric teams at Sunnybrook Health Sciences Centre are the same as those shared by trailblazers in the U.S. today. “We need to beef up our mental-health system: we are not training enough clinicians, not getting enough clinics built across the country,” says Victor Schwartz, the chief medical officer of the jed Foundation, a suicide-prevention group, in Solomon’s article. “Many clinicians are untrained in suicide prevention. We need preventive public-health initiatives on managing depression and anxiety in the pre-crisis stage. Every school should have an approach—but so should every employer and every small town.”

Figure 1: Mental Health Continuum c/o the Mental Health Commission of Canada.

Mental Health First Aid, understanding the Mental Health Continuum

Companies and schools are increasingly taking on the responsibility of looking out for their peers and colleagues through national organizational health programs like Mental Health First Aid, and others conducted by the Canadian Centre for Occupational Health and Safety. The Mental Health Commission of Canada developed a mental health continuum model (figure 1) that illustrates the non-binary spectrum of symptoms people may exhibit, and the recommended actions to take at different stages.

Canadian Armed Forces (CAR) focuses on resilience

One of the ways the CAR is addressing the incidence of depression and suicide among its ranks is by designing training programs that focus on resilience. The CAR defines resilience as “the capacity of a soldier to recover quickly, resist, and possibly even thrive in the face of direct/indirect traumatic events and adverse situations in garrison, training and operational environments”. The Road to Mental Readiness (R2MR) mental health training recently launched an accompanying app that can be used for goal-setting, self-talk, mental rehearsal, tactical breathing, attention control and working memory, and allows users to build personalized scripts and scenarios to achieve personal objectives.

Understand the warning signs and how to reach help

As the stigma of mental health and suicidal thoughts fades, more people are talking about signs, symptoms and reaching out for help.  May that discussion continue to shatter the misleading myth that if you ask people about suicidal feelings, it causes them to become suicidal. When really, any query from a place of concern can open an entirely new avenue to help, healing and, eventually, wellness.

Tania Haas also teaches post-traumatic growth meditation and movement to members of the military.

Are you in crisis?

Are you or someone you love having thoughts of suicide?  If at immediate risk, please call 911 or go to your nearest emergency department.  Or you can get support from the Canada Suicide Prevention Service by phone, text or chat:

• Phone: toll free 1.833.456.4566 or the Gerstein Centre Crisis Line at 416.929.5200

• Text: 45645

• Chat: crisisservicescanada.ca

• For residents of Quebec, call 1 866 APPELLE

Warning signs of suicide

Signs that might suggest someone is at risk of suicide include:

• thinking or talking about suicide

• having a plan for suicide

Other signs and behaviours that might suggest that someone is at risk of suicide include:

• withdrawal from family, friends or activities

• feeling like you have no purpose in life or reason for living

• increasing substance use, like drugs, alcohol and inhalants

• feeling trapped or that there’s no other way out of a situation

• feeling hopeless about the future or feeling like life will never get better

• talking about being a burden to someone or about being in unbearable pain

• anxiety or significant mood changes, such as anger, sadness or helplessness

What to do if someone you know exhibits warning signs of suicide

• Do not leave the person alone

• Remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt

• Canada Suicide Prevention Service by phone, text or chat (see above)

• Take the person to an emergency room or seek help from a medical or mental health professional

Other resources

• The Canadian Association for Suicide Prevention offers resources on suicide for survivors, those thinking about suicide, those who have been affected by someone who has attempted or died by suicide, and anyone who wants to help someone who has been affected in any way: https://suicideprevention.ca/

• The Canadian Mental Health Commission offers tools, readings, information and contacts specifically linked to both suicide prevention and surviving a suicideand surviving a suicide loss

• Distress and Crisis Centres can offer 24/7 support to those who are feeling suicidal. For a list of centres across Canada see https://suicideprevention.ca/need-help/

• Listen to interview and/or read the book: Myths about Suicide by Thomas Joiner (2011)
  

Ask a psychologist | Artificial intelligence that targets depression

Sophia the Robot, Alexa and Tesla are just the tip of the iceberg when it comes to the evolving relationship between artificial intelligence (AI) and human beings. For the field of mind health, AI appears to be a positive disruptor. Engineers have partnered with data scientists and physicians to curate and inform AI platforms on how to appropriately and readily manage symptoms and the treatment of  anxiety, depression and irregular sleep. AI has the potential to be preventive tool in reducing the probability of crises or relapses when mental health and addiction symptoms are flagged early.

I spoke with Gina DiGiulio, Director of Psychology at Medcan, to hear her take on the opportunities and risks of three technology products targeting mind health: Woebot, Ginger.io and Mind Me.

Woebot is a free therapy chatbot that launched as a stand-alone iOS app in January 2018. It was created by a clinical psychologist at Stanford University and uses cognitive behavioural therapy to treat depression by offering scripted and meaningful responses to users (Source: Business Insider, January 2018)

Ginger.io began in 2011 as a free tool that patients could set up to monitor symptoms and send alerts of escalation of mental health symptoms and episodes of crisis to their circle of care, which included their doctors, friends, and family members. Today, Ginger.io offers in-the-moment emotional support to all users via coaching, therapy, and psychiatry services, such as  medication management (Source: Ginger.io, Fast Company 2016)

mind.me uses a “set it and forget it” approach for users to manage mental health concerns. Personal data feeds into the application, which allows mind.me to ambiently monitor behaviour. When mind.me predicts the early symptoms of depression, notifications will be sent to the user’s predetermined circle of trust (Source: mind.me)

Advantages of AI

“These apps offer value and support when incorporated into therapy,” says Dr. DiGiulio. “Meeting with a psychologist, psychotherapist or a family physician can help with the categorization of a mental health condition, which leads to the best treatment strategy. Following that, these apps can help with staying the course and also send the clinician updates and indicators of concern if they arise, so we can offer timely care.”

Other advantages include:

• 24/7 access to care

• offer economic efficiency solutions

• can reach people in under-served areas, or in geographically challenging areas to access help

• are portable, can travel with you wherever you are

• can help reduce stigma associated with mental illness (e.g., if more people accept that depression, for example, is a global epidemic that has not yet been proportionally recognized, funded, or treated — perhaps more people will start getting the help they deserve)

• some of the products monitor symptom changes in real time, so clinicians can reach out to their clients when they need it the most, which can result in early intervention, relapse prevention, and streamlined aftercare solutions

Approach with caution

“Many or most of the apps are not currently regulated, so there is no real way to know how if the marketing promises match the actual outcomes. And, we don’t know if the strategies or approaches are based on empirically-sound science,” says Dr. DiGiulio.

Other risks and areas of concern with robot therapists:

• there is not enough long-term data on their effectiveness

• managing expectations when it comes to adherence: how long will people be willing to stick with an app as opposed to seeing a professional with whom they develop a productive and supportive rapport with?

• there may be valid privacy issues; users need to be aware of how their data is being collected, stored and possibly used

Final say … for now

“With mental health, as it is with most aspects of health, there are usually no cure-alls or magic pills. The best approaches are personalized and consider the evidence-based medicine as well as psycho-social and emotional health, lifestyle choices, as well as genetic history.

“The app advantage is the wider net of support to people in a timely and easy way, and doing so, break down the stigma of mental illness.  Through regular symptom monitoring, they can help detect symptoms of depression, anxiety, irregular sleep much more quickly, thus facilitating earlier intervention, which we know improves treatment outcomes. They can also be a great complement to therapy ‘homework’ and can help make inter-session time more effective by having clients track their mood and work on thought records,” says Dr. DiGiulio.

“These apps can certainly open the door to someone being introduced to therapy but the relationship component is missing, and sometimes you need that live connection with a person in order to really make an impact. We know that the therapeutic alliance is a vehicle through which progress in therapy can occur – an app can’t replace that human connection. And sometimes that human connection is the most therapeutic aspect of the live therapy session.”

Gina Di Giulio obtained her doctorate in psychology at the University of Ottawa and earned a masters in law with a health specialization from Osgoode Hall. In her clinical practice, she sees clients for a wide range of conditions including stress and anxiety, depression and relationships counselling. She is often consulted on individual counselling, organizational psychology as well as corporate wellness programs.

Ask a psychologist | How do you beat the winter blahs?

While Canada is known by the rest of the world as a winter-loving nation, the dark days and persistent time indoors can have a negative impact on some people’s health. For most, the key to combating the winter blahs is to embrace the frigid temperatures with your tribe through outdoor activities, sleeping enough, and eating well.  Or, take a cue from the Danish “hygge” way of life, and make cozy comforts like lounging in your knitwear by candlelight while sipping homemade soup a part of your routine.   These physical and social routines ensure regular exposure to sunlight and activity, which are essential year-round, but perhaps needed to be planned more deliberately in the winter.

For others, winter fatigue is more serious. Around 2 to 3% of Canadians experience a seasonal type of depression that can significantly impact their health and well-being. Another 15% will experience a milder form of the condition, which is also known as Seasonal Affective Disorder (S.A.D.). I sat down with two psychologists to understand more about this condition and when it’s wise to seek help.

Is S.A.D. a real condition or diagnosis?

“The general consensus is that it is indeed a real diagnosis,” says Dr. Ricardo Flamenbaum, a psychologist at Medcan. “Seasonal Affective Disorder, or seasonal depression, is listed in the DSM-5, the official mental health classification system  used by physicians, psychiatrists, and psychologists, as a sub-type of major depressive disorder; what we call depression.  What makes it different from depression is the seasonal qualifier or the seasonal pattern. That means it tends to come on during particular times of year, usually in the fall or winter, when there is a decrease of exposure to sunlight. It can also be associated to the changes our biological clocks undergo during time changes when the days get shorter.”

If someone suspects they have seasonal depression, when is it worth looking into with a professional?

Dr. Aline Rodrigues, also a psychologist at Medcan, says symptoms like low moods and low energy may be something to investigate if you find yourself  unable to function in your daily life.

Other symptoms include feeling down and/or tired most of the time; a general sense of malaise; and a need to sleep more than usual. Some people tend to overeat and have a higher craving of carbohydrates (like sugary treats). Seasonal depression may be the reason you are having difficulty going to work, or being at work and not working (i.e. presenteeism). You may be withdrawing from your circle of friends, or not performing at work or at school as well as usually do.

What are some recommended line of treatments?

Get outside and move more

Both psychologists recommended that we should all, regardless of where you fall on the spectrum, get outdoors as much as we can – which also forces us to be active. So layer up and lug on your boots, it’s time to go into the cold (and maybe even enjoy it). Some options to consider: walk over to the local seniors’ home and volunteer your skills or companionship; leave the car and walk to pick up some groceries; or take a spin on an ice rink you’ve never tried — for Torontonians, have you checked out the new outdoor rink under the Gardiner?

Try light therapy

For more mild levels of seasonal depression, increasing your exposure to sunlight may also be helpful.  Studies have shown an association with light exposure and mood; it’s been found to be just as beneficial as Cognitive Behavioural Therapy (CBT) and, when coupled with exercise, even more helpful.

Talk to an RD about vitamin D

Some practitioners recommend vitamin D to help stabilize mood in the winter months. Victoria Upshaw, a registered dietitian at Medcan, says although there is a strong correlation between vitamin D and S.A.D., there is no concrete cause and effect relationship.

“Researchers suspect that the many vitamin D receptors in the brain play a role in regulating serotonin.  At a minimum, vitamin D is also essential for bone density, immunity, and parathyroid hormone balance,” says Upshaw. “Health Canada recommends adults take 600-800 IU per day but most individuals need 1000 IU or more daily to help achieve healthy levels.  Do not exceed 4000 IU per day unless directed by a clinician as vitamin D is fat soluble and toxicity can lead to calcifications in the body.”

In order to make sure this is the right option for you, speak to a registered dietitian.

I think I may have S.A.D., what should I do?

Dr. Flamenbaum recommends getting a professional assessment before delving into the often risky world of self diagnosis.

“If someone came to me and told me they think they had seasonal depression, I would first do an assessment to determine the extent of their symptoms and the impact on their level of functioning. I would also get a detailed history to determine how recurrent it is; i.e. does it happen every winter?” says Dr. Flamenbaum.  “It’s also important to differentiate it from other forms of depression, including depressive reactions related to other factors (e.g., loss of job, relationship stress), as this would inform the focus of treatment and types of interventions that I would use. That’s why a full assessment would be important.”

When do you recommend booking a check-in with a physician or a psychologist?

“It’s always worth talking with a family doctor or psychologist, even if you are experiencing a milder version of seasonal depression,” says Dr. Rodrigues. “And it is definitely time to see someone if your symptoms or mindset are interfering with your daily life and affecting impact. A psychologist or other mental health professional will do a proper assessment and determine the best next steps for both immediate treatment and prevention in the future.”

5 ways to keep negative thoughts at bay

Negative thoughts can become so automatic we don’t even notice their running commentary of our lives. While negative thoughts can serve a purpose – to help us avoid danger and react quickly in an emergency – when they get out of hand, our health risks increase and life satisfaction diminishes.

Dr. Gina Di Giulio, Director of Psychology at Medcan, works with clients (in person or via video visit) to keep negative thoughts at bay. Here are her five suggestions:

1) The mindfulness approach: notice your worries without judgment

Rather than trying to control your negative thoughts, Dr. Di Giulio suggests observing your thoughts as if you are a witness to your own thoughts and feelings like you are noticing cars in traffic.

Once you’ve started to observe your thoughts, you will notice the judgmental or critical commentary that tags along. Judging thoughts or criticizing yourself makes you feel bad and can cause you to worry even more – and can enhance the body’s response to stress.

“Daily mindfulness practice helps with learning how to more readily ‘let go’ of negative thoughts,” says Dr. Di Giulio.

MRI scans show that after an 8-week course of mindfulness practice, our primal responses to stress (knee-jerk reactions) seem to be replaced by more tempered, thoughtful ones. Researchers have also noticed a reduction in the biomarkers of stress and inflammation like C-reactive proteins and cortisol, which are associated with disease.

2) Challenge negative thinking

Sometimes we can worry disproportionately to the actual risk at hand and those thoughts need to be challenged or they’ll take control.  Ask yourself questions like: ‘how many times have I worried about this or something similar, and how many times has my worry materialized?’ ‘When it did, was it as bad as I had imagined it to be?’

Reminding yourself about how many times you’ve actually worried about something, and how many times your worries have materialized can be a helpful tool to help examine your negative thinking more objectively, says Dr. Di Giulio.

3) Consider the worst case scenario

Asking yourself “what is the worst that can happen” and “how would I cope?” is also a helpful strategy.

“People often catastrophize and have images about their worries that end with the catastrophe being true. Thinking worries through to the end and asking yourself how you would cope, can be an incredibly powerful tool to help manage worries,” says Dr. Di Giulio. “Worrying underestimates our perceived coping skills, and leads us to believe that we wouldn’t be able to handle our worries if they came true, and in most cases, that is simply not the case.”

4)  Journal your thoughts and experiences

Writing your worries down –a technique can help you identify patterns in your worries. Are there any situations that are more likely to trigger your worries? Do you tend to worry about similar things again and again? Also, the act of reflecting on the joyous in our lives can increase one’s happiness. Twenty minutes of journaling at the end of the night about a positive experience can lead to positive thoughts and feelings.

5) Start today

Dr. Di Giulio recommends starting with apps like Headspace and Calm to help guide you through meditation. It might also be helpful to explore some of these patterns of negative thinking with a mental health professional who is trained in Cognitive Behavioural Therapy (CBT). CBT is an evidence-based treatment that teaches people how to more objectively evaluate their worries, and change problematic negative thinking patterns.

“Taking the time to observe, challenge, and reflect on the way we think can change the way our brain functions and how we respond to daily interactions,” says Dr. Di Giulio.”With these five simple suggestions, we have the potential to reclaim our calm for good.”

Photo by Naseem Buras on Unsplash